APPLICATION FOR CONCEALED WEAPON OR FIREARM …

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FDACS-16036 Rev. 07/17 Page 1 of 2Florida Department of Agriculture and Consumer ServicesDivision of LicensingAPPLICATION FOR CONCEALED WEAPON OR FIREARM LICENSEChapter 790, Florida StatutesPost Office Box 6687sTallahassee, FL 32314-6687s(850) I APPLICANT INFORMATION Read APPLICATION instructions before you begin. Place letter/number inside each box as shown SECURITY NUMBER ALIEN REGISTRATION NUMBERLAST NAME FIRST NAME MIRESIDENCE ADDRESS PHONE NUMBERRESIDENCE ADDRESS CONTINUED (SUITE, BLDG., APT., ETC.)CITY STATE ZIP CODE-MAILING ADDRESS IF DIFFERENT FROM ABOVEMAILING ADDRESS CONTINUED (SUITE, BLDG.)

2.o you hold an active certification from the Florida Criminal Justice Standards and Training Commission as a D ... or been deemed a habitual offender under the provisions of Section 856.011(3), Florida Statutes, or ... The information contained in this application and all attached documents is true and correct to the best of my knowledge.

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